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-- <br /> * APpLICAT\ON FOR SANITATION PERMIT <br /> | <br /> K��mplet� in Dup��m�� <br /> - ' � <br /> Application is hereby =o6u to the Sun Joaquin Local Huu|H` District for o permit to construct and imsfuUthe work herein 600c,l6o6. <br /> 4 <br /> This application is made in compliance with County Ordinance 49.7-W ... <br /> JOB ADDRESS AWVLOCATION 4y?------- Q', - Phone_V9n37$.4x------- <br /> Address------------------------------7,1 ---- <br /> Installation will serve: Residence K Apartment House [3 Commercial E3 trailer Court F1 Mofel [I Other E] <br /> Number of living units: Number of bedrooms �Z Number of baths <br /> Water Supply: Public system El Community system Ej Private X_ <br /> Cha.racter of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam 0 Clay Loam El Clay El Adobe Hardpan <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Seepage Pit: Distance to nearest well----------------------Distance from foundation--------------------Distance to nearest lot line----------------- <br /> Distance from founclation--, ------ Distance to nearest lot line-49------ <br /> Di I Field: . Distance from nearest well--f7w---- $4 <br />` Number of ||n of each line-���' --,,/�". ". .=.".- -------------------- <br /> Type of filter mo+eriuJ.& ep+h of filter mutnrinL'` -----' . <br /> � <br /> ------------------- <br /> ^�^ ' <br /> � . <br /> ---------I__her-e-by.-certify__tha-t I have__p-repare-d't-h-i-s__a-p-pi-i-c-a-tion and that.fhe work I be done in accordance with San Joaquin County <br /> Lo <br /> nr ----- (Owner Td C!�n t <br />/ <br />| "-=--'-'-«��-" ~ dj� <br /> Y*_------------_------ buildings, etc., must be filed application). <br /> (Plot plans, showing e of loi,location of system in relatio to wells,' <br /> FOR DEPARTMENT USE ONLY <br />/ <br /> DATE--- --- ----- -- -------------- 7 <br /> mmu//nG rEnx // ISSUED--------------------------------------------------------------------------------------- <br /> Alterations <br /> -- <br /> A}�ra�unsan6/or recovm*nduMnns:-----_-----_---------_-----'__-----_---_-__-_—_--_____����_�-� <br /> .__ _y <br /> _ <br /> _ <br /> �����'���''����''��������'�'���� <br /> ���'���'����'�����'��'''-__'---___'''--__.--'_�.'�''-_`-'-� <br /> '----___. _---'_---.__..��___''''___-''-_--''-__''''-_--��'�������``�������'��� <br /> _-------..-�.._ ---._-_----__--''--_-''''-_.''''-'__-'''__-�''___.'''__.'''---__''__'-'-''--�- <br /> ------''-4------------------'--'------'-----'�----------' -- '-'---' <br /> PERM|T`^No- ' ISSUED �/ -----(Date) FINAL INSPECTION BY:._-_1 ------ -A--------------- <br /> Date <br /> . __.. <br /> Dat*-''''—,_-___� �,�______.__.__. <br /> SAN <br /> JOAQU|N LOCAL HEALTH DISTRICT <br /> 130 South American Street <br /> ^ �& <br /> Stockton, California <br /> ES-cl_xw 9-SO W-1639 <br />